Microscopic and spectroscopic analysis of biogenic aerosols

Aerosol particles are important actors in the Earth’s atmosphere and climate system. They scatter and absorb sunlight, serve as nuclei for water droplets and ice crystals in clouds and precipitation, and are a subject of concern for public health. Atmospheric aerosols originate from both natural and anthropogenic sources, and emissions resulting from human activities have the potential to influence the hydrological cycle and climate. An assessment of the extent and impacts of this human force requires a sound understanding of the natural aerosol background. This dissertation addresses the composition, properties, and atmospheric cycling of biogenic aerosol particles, which represent a major fraction of the natural aerosol burden. The main focal points are: (i) Studies of the autofluo-rescence of primary biological aerosol particles (PBAP) and its application in ambient measure-ments, and (ii) X-ray microscopic and spectroscopic investigations of biogenic secondary organic aerosols (SOA) from the Amazonian rainforest.rnAutofluorescence of biological material has received increasing attention in atmospheric science because it allows real-time monitoring of PBAP in ambient air, however it is associated with high uncertainty. This work aims at reducing the uncertainty through a comprehensive characterization of the autofluorescence properties of relevant biological materials. Fluorescence spectroscopy and microscopy were applied to analyze the fluorescence signatures of pure biological fluorophores, potential non-biological interferences, and various types of reference PBAP. Characteristic features and fingerprint patterns were found and provide support for the operation, interpretation, and further development of PBAP autofluorescence measurements. Online fluorescence detection and offline fluorescence microscopy were jointly applied in a comprehensive bioaerosol field measurement campaign that provided unprecedented insights into PBAP-linked biosphere-atmosphere interactions in a North-American semi-arid forest environment. Rain showers were found to trigger massive bursts of PBAP, including high concentrations of biological ice nucleators that may promote further precipitation and can be regarded as part of a bioprecipitation feedback cycle in the climate system. rnIn the pristine tropical rainforest air of the Amazon, most cloud and fog droplets form on bio-genic SOA particles, but the composition, morphology, mixing state and origin of these particles is hardly known. X-ray microscopy and spectroscopy (STXM-NEXAFS) revealed distinctly different types of secondary organic matter (carboxyl- vs. hydroxy-rich) with internal structures that indicate a strong influence of phase segregation, cloud and fog processing on SOA formation, and aging. In addition, nanometer-sized potassium-rich particles emitted by microorganisms and vegetation were found to act as seeds for the condensation of SOA. Thus, the influence of forest biota on the atmospheric abundance of cloud condensation nuclei appears to be more direct than previously assumed. Overall, the results of this dissertation suggest that biogenic aerosols, clouds and precipitation are indeed tightly coupled through a bioprecipitation cycle, and that advanced microscopic and spectroscopic techniques can provide detailed insights into these mechanisms.rn

Long-term potentiation and neural network activity in the neonatal rat cerebral cortex in vivo

Long-term potentiation in the neonatal rat rnbarrel cortex in vivo rnLong-term potentiation (LTP) is important for the activity-dependent formation of early cortical circuits. In the neonatal rodent barrel cortex LTP has been so far only studied in vitro. I combined voltage-sensitive dye imaging with extracellular multi-electrode recordings to study whisker stimulation-induced LTP for both the slope of field potential and the number of multi-unit activity in the whisker-to-barrel cortex pathway of the neonatal rat barrel cortex in vivo. Single whisker stimulation at 2 Hz for 10 min induced an age-dependent expression of LTP in postnatal day (P) 0 to P14 rats with the strongest expression of LTP at P3-P5. The magnitude of LTP was largest in the stimulated barrel-related column, smaller in the surrounding septal region and no LTP could be observed in the neighboring barrel. Current source density analyses revealed an LTP-associated increase of synaptic current sinks in layer IV / lower layer II/III at P3-P5 and in the cortical plate / upper layer V at P0-P1. This study demonstrates for the first time an age-dependent and spatially confined LTP in the barrel cortex of the newborn rat in vivo. These activity-dependent modifications during the critical period may play an important role in the development and refinement of the topographic map in the barrel cortex. (An et al., 2012)rnEarly motor activity triggered by gamma and spindle bursts in neonatal rat motor cortexrnSelf-generated neuronal activity generated in subcortical regions drives early spontaneous motor activity, which is a hallmark of the developing sensorimotor system. However, the neuronal activity patterns and functions of neonatal primary motor cortex (M1) in the early movements are still unknown. I combined voltage-sensitive dye imaging with simultaneous extracellular multi-electrode recordings in the neonatal rat S1 and M1 in vivo. At P3-P5, gamma and spindle bursts observed in M1 could trigger early paw movements. Furthermore, the paw movements could be also elicited by the focal electrical stimulation of M1 at layer V. Local inactivation of M1 could significantly attenuate paw movements, suggesting that the neonatal M1 operates in motor mode. In contrast, the neonatal M1 can also operate in sensory mode. Early spontaneous movements and sensory stimulations of paw trigger gamma and spindle bursts in M1. Blockade of peripheral sensory input from the paw completely abolished sensory evoked gamma and spindle bursts. Moreover, both sensory evoked and spontaneously occurring gamma and spindle bursts mediated interactions between S1 and M1. Accordingly, local inactivation of the S1 profoundly reduced paw stimulation-induced and spontaneously occurring gamma and spindle bursts in M1, indicating that S1 plays a critical role in generation of the activity patterns in M1. This study proposes that both self-generated and sensory evoked gamma and spindle bursts in M1 may contribute to the refinement and maturation of corticospinal and sensorimotor networks required for sensorimotor coordination.rn

Interplay between BDNF,TrkB signalling and GABAergic inhibition in the visual cortex of mice

Der visuelle Kortex ist eine der attraktivsten Modellsysteme zur Untersuchung der molekularen Mechanismen der synaptischen Plastizität im Gehirn. Es hat sich gezeigt, dass der Wachstumsfaktor brain-derived-neurotrophic-factor (BDNF) und die GABAerge Hemmung während der Entwicklung eine essentielle Funktion in der Regulierung der synaptischen Plastizität im visuellen Kortex besitzen. BDNF bindet u.a. an TrkB Rezeptoren, die das Signal intrazellular an unterschiedliche Effektormoleküle weiter vermitteln. Außer BDNF sind auch andere TrkB-Rezeptor Agonisten in der Literatur beschrieben. Einer davon ist das kürzlich identifizierte Flavonoid 7,8-Dihydroxyflavone (7,8-DHF), welchem eine neurotrophe Wirkung zugeschrieben wird. Im ersten Abschnitt der vorliegenden Doktorarbeit wurde der Effekt dieses Agonisten auf die synaptische Übertragung und intrinsischen Zelleigenschaften im visuellen Kortex der Maus untersucht. Dies wurde mit Hilfe der whole-cell patch clamp Methode durchgeführt, wobei die synaptischen Eingänge der Pyramidalzellen der kortikalen Schicht 2/3 von besonderem Interesse waren.rnEine 30 minütige Inkubationszeit der kortikalen Schnitte mit 7,8 DHF (20µM) erzielte eine signifikante Reduktion der GABAergen Hemmung, während die glutamaterge synaptische Übertragung unverändert blieb. Des weiteren konnte in Gegenwart von 7,8 DHF eine Veränderung der intrinsischen neuronalen Zellmembraneigenschaften beobachtet werden. Dies wurde deutlich in der Erhöhung des Eingangwiderstandes und der Frequenz der induzierten Aktionspotentiale. Die chronische Applikation von 7,8 DHF in vivo bestätigte die selektive Wirkung von 7,8 DHF auf das GABAerge System. rnDie Rolle des BDNF-TrkB-Signalweges in der GABAergen Hemmung nach kortikalen Verletzungen ist bisher wenig verstanden. Eine häufig beschriebene elektrophysiologische Veränderung nach kortikaler Verletzung ist eine Reduktion in der GABAergen Hemmung. Im zweiten Abschnitt dieser Doktorarbeit wurde hierzu die Funktion des BDNF-TrkB-Signalweges auf die GABAerge Hemmung nach kortikaler Verletzung untersucht. Es wurde ein "ex-vivo/in-vitro“ Laser-Läsions Modell verwendet, wobei mittels eines Lasers im visuellen Kortex von WT und heterozygoten BDNF (+/−) Mäusen eine definierte, reproduzierbare Läsion induziert wurde. Nachfolgende elektrophysiologische Messungen ergaben, dass die Auswirkung einer Verletzung des visuellen Kortex auf die GABAerge Funktion signifikant von der basalen BDNF Konzentration im Kortex abhängt. Des weiteren konnte beobachtet werden, dass nach kortikaler Verletzung in WT Mäusen sowohl die Frequenz der basalen inhibitorischen, postsynaptischen Potentiale (mIPSCs) reduziert war, als auch ein erhöhtes Paired-Pulse Verhältnis vorlag. Diese Ergebnisse deuten auf Veränderungen der präsynaptischen Funktion inhibitorischer Synapsen auf Pyramidalneurone hin. Im Gegensatz dazu konnte in BDNF (+/−) mice Mäusen eine erhöhte und gleichzeitig verlängerte mIPSC-Amplitude beobachtet werden, induziert durch Reizung afferenter Nervenfasern. Hieraus lässt sich schließen, dass kortikale Verletzungen in BDNF (+/−) mice Mäusen Auswirkungen auf die Eigenschaften von postsynaptischen GABAA-Rezeptoren haben. Die nachfolgende Gabe eines TrkB-Rezeptor Antagonisten bestätigte diese Ergebnisse für das GABAerge System post-Läsion. Dies zeigt auch, dass die Änderungen der synaptischen Hemmung nicht auf eine Reduktion der BDNF-Konzentration zurückzuführen sind. Zusammengefasst zeigen die Ergebnisse der vorliegenden Arbeit, dass der BDNF-TrkB Signalweg eine wichtige Rolle in der Reorganisation der GABAergen Hemmung nach kortikalen Verletzungen spielt. So könnte ein TrkB-Rezeptor Agonist, wie das kürzlich entdeckte 7,8-DHF, über eine Modulation der BDNF-TrB Signalkaskade pharmakologisch die funktionelle Reorganisation des Kortex nach einer fokalen Gehirnverletzung fördern. rnrn

Internal characteristics, chemical compounds and spectroscopy of sapphire as single crystals

In this study more than 450 natural sapphire samples (most of basaltic type) collected from 19 different areas were examined. They are from Dak Nong, Dak Lak, Quy Chau, two unknown sources from the north (Vietnam); Bo Ploi, Khao Ploi Waen (Thailand); Ban Huay Sai (Laos); Australia; Shandong (China); Andapa, Antsirabe, Nosibe (Madagascar); Ballapana (Sri Lanka); Brazil; Russia; Colombia; Tansania and Malawi. rnThe samples were studied on internal characteristics, chemical compositions, Raman-, luminescence-, Fourier transform infrared (FTIR)-, and ultraviolet-visible-near infrared (UV-Vis-NIR)- spectroscopy. The internal features of these sapphire samples were observed and identified by gemological microscope, con focal micro Raman and FTIR spectroscopy. The major and minor elements of the samples were determined by electron probe microanalysis (EPMA) and the trace elements by laser ablation inductively coupled plasma mass spectrometry (LA-ICP-MS). rnThe structural spectra of sapphire were investigated by con focal Raman spectroscopy. The FTIR spectroscopy was used to study the vibration modes of OH-groups and also to determine hydrous mineral inclusions in sapphire. The UV-Vis-NIR absorption spectroscopy was used to analyze the cause of sapphire color. rnNatural sapphires contain many types of mineral inclusions. Typically, they are iron-containing inclusions like goethite, ilmenite, hematite, magnetite or silicate minerals commonly feldspar, and often observed in sapphires from Asia countries, like Dak Nong, Dak Lak in the south of Vietnam, Ban Huay Sai (Laos), Khao Ploi Waen and Bo Ploi (Thailand) or Shandong (China). Meanwhile, CO2-diaspore inclusions are normally found in sapphires from Tansania, Colombia, or the north of Vietnam like Quy Chau. rnIron is the most dominant element in sapphire, up to 1.95 wt.% Fe2O3 measured by EPMA and it affects spectral characteristics of sapphire.rnThe Raman spectra of sapphire contain seven peaks (2A1g + 5Eg). Two peaks at about 418.3 cm-1 and 577.7 cm-1 are influenced by high iron content. These two peaks shift towards smaller wavenumbers corresponding to increasing iron content. This shift is showed by two equations y(418.3)=418.29-0.53x andy(577.7)=577.96-0.75x, in which y is peak position (cm-1) and x is Fe2O3 content (wt.%). By exploiting two these equations one can estimate the Fe2O3 contents of sapphire or corundum by identifying the respective Raman peak positions. Determining the Fe2O3 content in sapphire can help to distinguish sapphires from different origins, e.g. magmatic and metamorphic sapphire. rnThe luminescence of sapphire is characterized by two R-lines: R1 at about 694 nm and R2 at about 692 nm. This characteristic is also influenced by high iron content. The peak positions of two R-lines shift towards to smaller wavelengths corresponding to increasing of iron content. This correlation is showed by two equations y(R_2 )=692.86-0.049x and y(R_1 )=694.29-0.047x, in which y is peak position (nm) of respective R-lines and x is Fe2O3 content (wt.%). Two these equations can be applied to estimate the Fe2O3 content of sapphire and help to separate sapphires from different origins. The luminescence is also applied for determination of the remnant pressure or stress around inclusions in Cr3+-containing corundum by calibrating a 0-pressure position in experimental techniques.rnThe infrared spectra show the presence of vibrations originating from OH-groups and hydrous mineral inclusions in the range of 2500-4000 cm-1. Iron has also an effect upon the main and strongest peak at about 3310 cm-1. The 3310 cm-1 peak is shifted to higher wavenumber when iron content increases. This relationship is expressed by the equation y(3310)=0.92x+3309.17, in which y is peak position of the 3310 cm-1 and x is Fe2O3 content (wt.%). Similar to the obtained results in Raman and luminescence spectra, this expression can be used to estimate the Fe2O3 content and separate sapphires from different origins. rnThe UV-Vis-NIR absorption spectra point out the strong and sharp peaks at about 377, 387, and 450 nm related to dispersed Fe3+, a broad band around 557 and 600 nm related to intervalence charge transfer (IVCT) Fe2+/Ti4+, and a broader band around 863 nm related to IVCT of Fe2+/Fe3+. rnGenerally, sapphires from different localities were completely investigated on internal features, chemical compounds, and solid spectral characteristics. The results in each part contribute for identifying the iron content and separate sapphires from different localities order origins. rn

Language lateralization correlates with verbal memory performance in children with focal epilepsy

PURPOSE: Assessment of language dominance with functional magnetic resonance imaging (fMRI) and neuropsychological evaluation is often used prior to epilepsy surgery. This study explores whether language lateralization and cognitive performance are systematically related in young patients with focal epilepsy. METHODS: Language fMRI and neuropsychological data (language, visuospatial functions, and memory) of 40 patients (7-18 years of age) with unilateral, refractory focal epilepsy in temporal and/or frontal areas of the left (n = 23) or right hemisphere (n = 17) were analyzed. fMRI data of 18 healthy controls (7-18 years) served as a normative sample. A laterality index was computed to determine the lateralization of activation in three regions of interest (frontal, parietal, and temporal). RESULTS: Atypical language lateralization was demonstrated in 12 (30%) of 40 patients. A correlation between language lateralization and verbal memory performance occurred in patients with left-sided epilepsy over all three regions of interest, with bilateral or right-sided language lateralization being correlated with better verbal memory performance (Word Pairs Recall: frontal r = -0.4, p = 0.016; parietal r = -0.4, p = 0.043; temporal r = -0.4, p = 0.041). Verbal memory performance made the largest contribution to language lateralization, whereas handedness and side of seizures did not contribute to the variance in language lateralization. DISCUSSION: This finding reflects the association between neocortical language and hippocampal memory regions in patients with left-sided epilepsy. Atypical language lateralization is advantageous for verbal memory performance, presumably a result of transfer of verbal memory function. In children with focal epilepsy, verbal memory performance provides a better idea of language lateralization than handedness and side of epilepsy and lesion.

Inherited cavernous malformations of the central nervous system: clinical and genetic features in 19 Swiss families

Cavernous malformations (CCMs) are benign, well-circumscribed, and mulberry-like vascular malformations that may be found in the central nervous system in up to 0.5% of the population. Cavernous malformations can be sporadic or inherited. The common symptoms are epilepsy, hemorrhages, focal neurological deficits, and headaches. However, CCMs are often asymptomatic. The familiar form is associated with three gene loci, namely 7q21-q22 (CCM1), 7p13-p15 (CCM2), and 3q25.2-q27 (CCM3) and is inherited as an autosomal dominant trait with incomplete penetrance. The CCM genes are identified as Krit 1 (CCM1), MGC4607 (CCM2), and PDCD10 (CCM3). Here, we present the clinical and genetic features of CCMs in 19 Swiss families. Furthermore, surgical aspects in such families are also discussed.

Coronal plane segmental flexibility in thoracic adolescent idiopathic scoliosis assessed by fulcrum-bending radiographs

Knowledge about segmental flexibility in adolescent idiopathic scoliosis is crucial for a better biomechanical understanding, particularly for the development of fusionless, growth-guiding techniques. Currently, there is lack of data in this field. The objective of this study was, therefore, to compute segmental flexibility indices (standing angle minus corrected angle/standing angle). We compared segmental disc angles in 76 preoperative sets of standing and fulcrum-bending radiographs of thoracic curves (paired, two-tailed t tests, p < 0.05). The mean standing Cobb angle was 59.7 degrees (range 41.3 degrees -95 degrees ) and the flexibility index of the curve was 48.6\% (range 16.6-78.8\%). The disc angles showed symmetric periapical distribution with significant decrease (all p values <0.0001) for every cephalad (+) and caudad (-) level change. The periapical levels +1 and -1 wedged at 8.3 degrees and 8.7 degrees (range 3.5 degrees -14.8 degrees ), respectively. All angles were significantly smaller on the-bending views (p values <0.0001). We noted mean periapical flexibility indices of 46\% (+1), 49\% (-1), 57\% (+2) and 81\% (-2), which were significantly less (p < 0.001) than for the group of remote levels 105\% (+3), 149\% (-3), 231\% (+4) and 300\% (-4). The discal and bony wedging was 60 and 40\%, respectively, and mean values 35 degrees and 24 degrees (p < 0.0001). Their relationship with the Cobb angle showed a moderate correlation (r = 0.56 and 0.45). Functional, radiographic analysis of idiopathic thoracic scoliosis revealed significant, homogenous segmental tethering confined to four periapical levels. Future research will aim at in vivo segmental measurements in three planes under defined load to provide in-depth data for novel therapeutic strategies.

Neuronal polarity selection by topography-induced focal adhesion control

Interaction between differentiating neurons and the extracellular environment guides the establishment of cell polarity during nervous system development. Developing neurons read the physical properties of the local substrate in a contact-dependent manner and retrieve essential guidance cues. In previous works we demonstrated that PC12 cell interaction with nanogratings (alternating lines of ridges and grooves of submicron size) promotes bipolarity and alignment to the substrate topography. Here, we investigate the role of focal adhesions, cell contractility, and actin dynamics in this process. Exploiting nanoimprint lithography techniques and a cyclic olefin copolymer, we engineered biocompatible nanostructured substrates designed for high-resolution live-cell microscopy. Our results reveal that neuronal polarization and contact guidance are based on a geometrical constraint of focal adhesions resulting in an angular modulation of their maturation and persistence. We report on ROCK1/2-myosin-II pathway activity and demonstrate that ROCK-mediated contractility contributes to polarity selection during neuronal differentiation. Importantly, the selection process confined the generation of actin-supported membrane protrusions and the initiation of new neurites at the poles. Maintenance of the established polarity was independent from NGF stimulation. Altogether our results imply that focal adhesions and cell contractility stably link the topographical configuration of the extracellular environment to a corresponding neuronal polarity state.

The effect of alternative neuronal differentiation pathways on PC12 cell adhesion and neurite alignment to nanogratings

During development and regeneration of the mammalian nervous system, directional signals guide differentiating neurons toward their targets. Soluble neurotrophic molecules encode for preferential direction over long distances while the local topography is read by cells in a process requiring the establishment of focal adhesions. The mutual interaction between overlapping molecular and topographical signals introduces an additional level of control to this picture. The role of the substrate topography was demonstrated exploiting nanotechnologies to generate biomimetic scaffolds that control both the polarity of differentiating neurons and the alignment of their neurites. Here PC12 cells contacting nanogratings made of copolymer 2-norbornene ethylene (COC), were alternatively stimulated with Nerve Growth Factor, Forskolin, and 8-(4-chloro-phenylthio)-2'-O-methyladenosine-3',5'-cyclic (8CPT-2Me-cAMP) or with a combination of them. Topographical guidance was differently modulated by the alternative stimulation protocols tested. Forskolin stimulation reduced the efficiency of neurite alignment to the nanogratings. This effect was linked to the inhibition of focal adhesion maturation. Modulation of neurite alignment and focal adhesion maturation upon Forskolin stimulation depended on the activation of the MEK/ERK signaling but were PkA independent. Altogether, our results demonstrate that topographical guidance in PC12 cells is modulated by the activation of alternative neuronal differentiation pathways.

Analysis of coronary bifurcations by intravascular ultrasound and virtual histology

Background Regional differences in shear stress have been identified as reason for early plaque formation in vessel bifurcations. We aimed to investigate regional plaque morphology and composition using intravascular ultrasound (IVUS) and virtual histology (IVUS–VH) in coronary artery bifurcations. Methods We performed IVUS and IVUS–VH studies at coronary bifurcations to analyze segmental plaque burden and composition of different segments in relation to their orientation to the bifurcation. Results A total of 236 patients with a mean age of 59 ± 11 years (69% male) were analyzed. Plaque burden was higher at the contralateral vessel wall facing the bifurcation compared to the ipsilateral vessel wall and this difference was true for proximal and distal segments (proximal: 37 ± 12% and 45 ± 15% for segments at the ipsilateral and contralateral vessel wall, respectively, p < 0.001; distal: 37 ± 10% and 47 ± 15% for segments at the ipsilateral and contralateral vessel wall, respectively, p < 0.001). In addition, these segments exhibited a higher proportion of dense calcium and a lower proportion of fibrous tissue and fibro fatty tissue. Conclusions Segments on the contralateral wall of the bifurcation which have previously been identified as regions with low shear stress not only exhibited a higher plaque burden, but also a higher degree of calcification.

Hepatocellular carcinoma and regenerating nodule in a 3-year-old child with Alagille syndrome

In Alagille syndrome, routine follow-up imaging of the liver plays an important role in detecting early parenchymal changes and to evaluate portal hypertension. Modern contrast-enhanced imaging methods not only allow early detection of focal liver lesions, but also enable further characterization of their nature and guide biopsy procedures. We present the US and MR imaging findings of hepatocellular carcinoma and a regenerating nodule in a 3-year-old child with Alagille syndrome.

Focal cystic high-attenuation lesions: characterization in renal phantom by using photon-counting spectral CT--improved differentiation of lesion composition

To evaluate the capability of spectral computed tomography (CT) to improve the characterization of cystic high-attenuation lesions in a renal phantom and to test the hypothesis that spectral CT will improve the differentiation of cystic renal lesions with high protein content and those that have undergone hemorrhage or malignant contrast-enhancing transformation.

Diffusion-weighted MR imaging of native and transplanted kidneys

Applications of diffusion-weighted (DW) magnetic resonance (MR) imaging outside the brain have gained increasing importance in recent years. Owing to technical improvements in MR imaging units and faster sequences, the need for noninvasive imaging without contrast medium administration, mainly in patients with renal insufficiency, can be met successfully by applying this technique. DW MR imaging is quantified by the apparent diffusion coefficient (ADC), which provides information on diffusion and perfusion simultaneously. By using a biexponential fitting process of the DW MR imaging data, these two entities can be separated, because this type of fitting process can serve as an estimate of both the perfusion fraction and the true diffusion coefficient. DW MR imaging can be applied for functional evaluation of the kidneys in patients with acute or chronic renal failure. Impairment of renal function is accompanied by a decreased ADC. Acute ureteral obstruction leads to perfusion and diffusion changes in the affected kidney, and renal artery stenosis results in a decreased ADC. In patients with pyelonephritis, diffuse or focal changes in signal intensity are seen on the high-b-value images, with increased signal intensity corresponding to low signal intensity on the ADC map. The feasibility and reproducibility of DW MR imaging in patients with transplanted kidneys have already been demonstrated, and initial results seem to be promising for the assessment of allograft deterioration. Overall, performance of renal DW MR imaging, presuming that measurements are of high quality, will further boost this modality, particularly for early detection of diffuse renal conditions, as well as more accurate characterization of focal renal lesions.

Evidence for a new fumarate hydratase gene mutation in a unilateral type 2 segmental leiomyomatosis

Multiple cutaneous and uterine leiomyomata syndrome (MCUL; MIM 150800) is a rare condition that sometimes predisposes to renal cancer. It is caused by deleterious mutations in the fumarate hydratase (FH) gene. In many patients, skin leiomyomas have been reported to develop according to a segmental type 1 or type 2 distribution. We report a patient showing multiple leiomyomas distributed according to a segmental type 2 distribution and covering several areas exclusively on the left side of his body.